中西医结合治疗肺癌患者的白细胞介素-2系统、T细胞及红细胞免疫系统的动态观察与临床评估

Dynamic Observation and Clinical Significance of Integrated Traditional Chinese and Western Medicine on Interleukin-2 System, T Cell and Erythrocyte Immune System in Patients of Lung Cancer

目的 :观察中西医结合治疗肺癌患者的白细胞介素 2 (IL 2 )系统、T细胞及红细胞免疫系统动态改变与临床评估。方法 :随机将肺癌患者分为两组 :Ⅰ组 (化疗加中药 ) 2 5例 ,Ⅱ组 (化疗 ) 2 3例。动态观察治疗前后免疫指标及生存质量、临床证候与瘤体改变。且以健康人为对照。结果 :(1)肺癌患者血清IL 2与可溶性白细胞介素 2受体 (sIL 2R)分别显著低于与高于对照组。治疗后上述指标分别显著回升和下降。尤以Ⅰ组改善为著。但仍与对照组有显著差异 ;且两组肺癌患者IL 2与sIL 2R之间呈高度负相关。 (2 )两组肺癌患者CD3、CD4 、CD4 /CD8均显著低下。而CD8则显著高于对照组 ;红细胞免疫指标红细胞C3b受体花环 (RBC C3bRR)、红细胞免疫复合物花环 (RBC ICR)分别显著低于与高于对照组 ;治疗后均有所改善 ,呈相对应负性改变 ,也以Ⅰ组明显。CD4 /CD8则较治疗前有显著改善 ,但除CD8外 ,余均仍显著低于对照 ;进而分别显示CD4 /CD8比值与RBC C3bRR间呈高度正相关。 (3)生存质量、临床证候和实体瘤改变等方面评估均为Ⅰ组优于Ⅱ组。结论 :中西医结合治疗肺癌对于改善生存质量、临床证候和实体瘤改变取得了较好的疗效 ,尤其对于中晚期肺癌。

To study the dynamic changes and its clinical significance of integrated traditional Chinese and western medicine (TCM WM) on IL 2 system, T cell and erythrocyte immune system in patients of lung cancer. Methods: Forty eight cases with lung cancer were randomly divided into two groups: TCM WM group (group Ⅰ) and the chemotherapy group (group Ⅱ); and 20 healthy subjects were simultaneously compared. The relevant immune indices, clinical symptoms and signs, changes of solid tumor and living quality were dynamically observed. Results: (1)The serum IL 2 level of lung cancer patients were significantly lower, while sIL 2R level higher than that of the healthy subjects. And they were raised and lowered respectively after treatment, especially in the group Ⅰ, but different from the control group yet. And there were highly negative correlation between IL 2 and sIL 2R levels. (2) The percentage of CD 3, CD 4 and the ratio CD 4/CD 8 were decreased markedly in both groups, except CD 8 which was increased markedly. And the percentage of RBC C3b RR was obviously lower, while that of RBC ICR was obviously higher. But the above mentioned indices could be improved after treatment, especially in the group Ⅰ, and there were highly positive correlation between CD 4/CD 8 ratio and RBC C3bRR. (3) After treatment, all above mentioned indices were changed significantly to their corresponding opposits. However, in regard to the degree of improvement, the patients of group Ⅰ were in a better position than those of group Ⅱ. At the same time, improvement of their clinical symptoms and signs, change of solid tumor and living quality also showed advantageous. Conclusion: The therapeutic superiority of TCM WM on lung cancer may be related with the modulation on immune function. Thus we can say that the effect of TCM WM is better than that of chemotherapy alone.